More On Medical Battery

Lauren posted yesterday on a disgusting story about an orthopedic surgeon who has been placing temporary tattoos on his patients during surgery. The shit hit the fan when this asshole placed a red rose tattoo under the panty line of a female patient, who didn’t discover the tattoo until her husband saw it. Lauren has more of the details and an excellent take, so please read her post.

I want to give you my take on this as a PhysioProf who works at a highly prestigious medical school and academic medical center:

As someone who spends a substantial portion of his professional time teaching medical students, I can tell you that this kind of attitude–that physicians are gods, not mere mortals, and wield power over other human beings that no one dare question–is inculcated in them from the very beginning of medical training. It is an ugly secret of our medical training system. And the more prestigious the institutions where physicians receive their training, the more overweening is this attitude.

Anything that a physician calls a “joke” or “for the patient’s benefit” simply is that, and how dare anyone question that judgment!

Surgeons are the worst, they cut people’s fucking asses open with sharp knives, and they are basically used to functioning as dictators in the operating room. These leads to the development of attitudes which makes perfect sense in light of the practical demands of surgery. But they do not work well in other areas of life. Put a surgeon in charge of any enterprise that requires leadership through persuasion or consensus, and you are totally fucking fucked.

Anyway, this is a long-winded way of stating that this incident doesn’t surprise me one fucking bit. From a legal standpoint, btw, it is clearly a battery, as these patients gave informed consent to a particular operation, and not to having temporary tattoos placed on their bodies while unconscious. It is battery in exactly the same way it would be battery if you put a temporary tattoo on the body of a stranger asleep at the beach. (Jill, who is boning up for bar exam, can probably weigh in with a better explanation of why this tattoing shit is battery.)

82 Responses to More On Medical Battery

Having worked with a lot of doctors over the past few years – omg yes. I got through my time working with spinal surgeons by telling that stupid joke over and over again – “What’s the difference between God & a doctor?” “God doesn’t think he’s a doctor.”

My fav was listening to doctors standing around smoking (right near the entrance of the no-smoking hospital, which meant everyone had to go through their damned smoke) complaining loudly about how SOME patients just coudn’t be convinced to give up their bad habits for their health.

A British friend of mine is in a psychiatric institution, trying to get better after a major case of PTSD. A couple of days ago, she had a one-on-one session with a psychiatrist. She was facing the door and the doctor, a man, was between the door and herself. She was understandably nervous and asked him to switch places. HE asked why and she said, “the last time a man stood between me and the door, he strangled me”. And he said “but I am a doctor”.

I’ve fired two doctors because they had crappy bedside manners. One was a surgeon who kept calling me “young lady” (I was, at most, five or six years younger than he was) and told me lose weight before he’d operate (I wear a size sixteen, and the condition I was seeing him for was inherited from my size six mother).

The other was an otolaryngologist I went to for a second opinion on a benign but potentially serious condition. He was so eager to operate, using a technique that would have made me deaf in one ear, that I couldn’t wait to get out of him. The worst was that when I flinched at the mention of surgery, he eagerly informed me that the local hospital had just gotten a gamma knife and he was being trained on it, and he’d be more than happy to use it on me as one of his very first patients!

Needless to say, I’m now under the care of a very nice doctor in Boston –

I think that sometimes the medical professsion in general abuses their power when the patient is vulnerable. It’s like they get off on that power over somebody. My bad experience was with an anestesiologist (I know I just butchered that word but the spelling won’t come to me). It was when I had an epideral with my second child. My partner was taking our son to the waiting room to meet the sitter and I asked him to wait for him to come back so he could be there to hold me so I didn’t move and he said I’d rather not so I was like well okay and then he couldn’t get it in right so I moved and the pain was horrible I said a few choice words not at him but just in response to the pain and he responded do you talk like that in front of your child. I was in utter disbelief he was lecturing me during a procedure. I don’t need some guy projecting his views on me. I wonder if this guy had a male patient if he would have tried to pull this shit. Given the circumstances i couldn’t do much of anything then but before I lest the hospital I did complain that I thought it was inappropriate. I don’t anything happened because of my complaint.

A British friend of mine is in a psychiatric institution, trying to get better after a major case of PTSD. A couple of days ago, she had a one-on-one session with a psychiatrist. She was facing the door and the doctor, a man, was between the door and herself. She was understandably nervous and asked him to switch places. HE asked why and she said, “the last time a man stood between me and the door, he strangled me”. And he said “but I am a doctor”.

…

And this, friends, is why MDs shouldn’t be allowed to do therapy. I know, I know, I’ve got my clinical psych bias, but come on. A first year MA student would have known better than to say that, and probably to do that. This is why psychiatrists piss me off, they’ve got the whole arrogant medical background, a slavish devotion to biobasis and pharmacology, and half the psychology training of a decent MA, much less a PsyD. A little knowledge is a dangerous thing.

I can tell you that this kind of attitude–that physicians are gods, not mere mortals, and wield power over other human beings that no one dare question–is inculcated in them from the very beginning of medical training. It is an ugly secret of our medical training system.

Actually, it’s not more a “secret” than it is a secret that McCain is white, or that the sky is blue, or that things fall down. Anyone who has been to the doctor, or a hospital, or a dentist has most likely encountered the “I have a medical degree therefore I am GOD” attitude.

I am currently living with Sarcoidosis and as such have had to deal with doctors more than I ever have had to at any previous point in my life. I have learned that one must take control of your medical treatment. The establishment as it currently exists does not treat people as individuals, it treats people like they are their disease Having my health care done at a teaching hospital I have been in a good position to see the ways in which this attitude is reinforced. Because patients are separated from their individuality doctors feel that they have the right to say or do offensive things. The way that medicine is taught needs to be changed. When one is ill that last thing that you need to is have to engage with your doctor on the way that she/he is othering you or creating you as less than.

Before I worked with doctors, I thought the doctors that treated me poorly were just… you know, individual jerks. Then I started working for doctors.

In my experience, which is in no way universal, I found that male doctors were more arrogant than female doctors, but I primarily worked with female doctors in different specialities – pediatric neurosurgery instead of spinal, for example.

A little too generalized reaction, perhaps, but there’s more that everyone needs to know for future self-advocacy during any procedure and for anytime one will be undergoing sedation or general anesthesia:

There are specific roles that operating room staff have across all types of procedures. The circulating nurse is always a registered nurse (licensed as a registered nurse) and has clinical expertise in peri-operative nursing.

He or she is in charge of the patient’s safety at all times from the moment the patient enters the operating room until the moment the patient leaves. The circulating nurse is the person charged with calling the pre-surgery time-out to verify the procedure and its location to be performed. The circulator continually surveys everyone and eveything in the room to assure that sterile technique is maintained, to identify breaks in technique and to make instant corrections. The cirulator also participates in the pre andpost procedure “counts” – a manual two person counting and reconciling for every sharp and peice of euiqpment which entered the patient’s body during the procedure and which was not specifically intended to remain permanently (as in a replacement joint, a heart valve or a permanent pacemaker) or temporarily – as in a surgical wound drain.

The circulator keeps the surgical field in view at all times, and if anyone performs outside the accepted standards of practice and care for the specific procedure being done on a patient, it’s the circulating RN who has the legal duty to stop it.

So there are two people at fault for this malpractice and assault and battery.

A scrub nurse or a surgical technician may be someone who is licensed as a registered nurse, a licensed practical nurse or simply have in-hospital training to handle the instruments for surgical procedures. They work under the direct supervision of the circulating nurse (or a surgeon in an office setting).

Others who may or may not be on any particular surgical team include the anesthesiologist – a medical doctor with post-graduate clinical education/training in the use and application of anesthetic agents, airway management and vascular access; a certified registered nurse anesthetist, who is a registered nurse with additional clinical education/training at the masters or doctoral level in anesthesia administration, airway management and vascular access; surgical assistants or residents; and medical and nursing students.

One underlying problem is that almost all nurses work as employees for patient care institutions, thus dividing their loyalty between the employer for job security and income and to the patients, by which statute and ethics mandate primary concern.

It’s always the patient who loses when nurses are not free to advocate effectively.

“He vigorously denies that any action of his was intended to offend the patient,” Agre said, noting that the marks the surgeon has left on his patients “are like children’s tattoos. Kids put them on themselves and they wash right off.”

Way to miss the point. It isn’t the tattoo, it’s the fact that he put the tattoo on her- the tattoo itself is just the evidence.

I’ve met a lot of arrogant bankers and landscapers. A few arrogant janitors. Arrogant grocery clerks and mechanics. Even an arrogant teenager here and there. Sometimes the fog is so thick, you can’t see the horizon.

My mom, who worked as a nurse for many years, recommended her GP to me when mine retired a few years ago. Her reason: “It’s so nice to see a doctor who isn’t a complete ASSHOLE!”

How I got my current OB/GYN … when I was 14, she was the only doctor who wasn’t 100% confident in her belief that my abdominal pain was caused by a harmless cyst. After seeing countless doctors over the course of 6 months of steadily increasing pain, she was the only one to take me seriously when I told her, “I can’t deal with this anymore.” In surgery, she discovered I had a fallopian tube torsion that had become gangrenous.

Afterward, my mother told me that the doctor told HER that she’d started crying after she saw the gangrene, because “she (the doctor) couldn’t imagine how much pain I’d been in.” I was so touched by the fact that she could feel such empathy for a patient. She actually thought about what I had been going through. That sort of compassion comes standard with your average human being, but in doctors it’s distressingly hard to find.

To sum things up, I’ve continued to go back to her for minor problems over the years and she has never disappointed me. I apologize for the long post, but I thought maybe some would appreciate a story about a genuinely good doctor among all this atrocity.

And yes, I think what that doctor did to his patient (with the tattoo) was atrocious. When will men realize that a woman’s lack of consciousness is not an open invitation to do whatever the fuck they want to her unconscious body, no matter how “funny” they think it might be?

after reading these stories i feel so lucky. ive had 15 kidney surgeries all with the same doctor and hes been amazing in every way. he has cried with my mother while discussing my health. when i was trying to deal with my health condition and be a normal teenager simultaneously he would let me postpone surgeries for social events i felt were important, and he wrote me notes to get me out of phys ed when he found out i was being harrassed for being out and bi in the locker room. my last surgery was an emergency one, i had managed to move a kidney stone by drinking too much, and when i was wheeled into the operating room while i was slowly succombing to the anesthesia he asked what i had drank then joked with me that perhaps next time i should stick with one bottle of wine insteasd of two.

my shrink is amazing too as is my GP. my dentist is so great i dont even mind getting dental work done.

im sorry other peoples experiences are so awful. and the tattoo thing is soooooooooooo wrong.

I’d feel much more comfortable if someone put a tatoo on me while I was asleep on the beach than during surgery. At least on the beach there’s a sense of being in public, there are people around that you may or may not trust — while there’s always a right to bodily integrity, there’s not necessarily an expectation of privacy and confidence in those around you. All that is decidedly NOT the case in an OR. There is an implicit and explicit understand of trust between the patient and the staff, as well as an understanding of exactly what’s going to go on.

Speaking as a medical student, that kind of attitude is not promoted by the medical school I attend. If people come in with that attitude and manage to make it to practice, I am not saying I would be surprised. But, it is definitely not an encouraged attitude toward patients here.

It isn’t an explicit component of the training–“you are gods among men”–but rather implicit in the way that everyone else involved in the entire health care enterprise treats medical students, and then physicians/surgeons.

I still don’t get it. You didn’t say anything in this column either. I’ve had my share of insanely horrible doctors, including the one who responded to my concern about losing 20 lbs in a month a half with “Most women would like that”.

I’m also in medical school and your comment about explicit training vs implicit indoctrination is right on. (And would have been a better topic, imho) None of my profs have said “You are better than your patients” but in pathology we’re taught that the way you treat cancer is to cut it off (unless its on a fertile woman’s uterus), in microbiology we’re taught that those who drink unpasteurized milk or have “homosexual sex” are asking for bacterial infections, so on and so forth.

The problem lays in the fact that you have a bunch of students with no background in critical thought being taught by professors with no respect for it.

It’s not that hard to avoid the implicit indoctrination – that’s where common sense comes in, also, knowledge of people.

Some attending physicians (that’s the leader of the medical care team / teaching unit that includes residents and medical students) and residents tell their juniors tips. These are some of mine.
1. If an experienced nurse questions your order or suggests a possible diagnosis or points out a problem – LISTEN. Said nurse has way more experience than you, the medical student, and has been listening to attendings et al rounding (seeing patients and later discussing their care) for a loooooong time.
2. Don’t piss off the nurses and unit clerks. They have info you need and can do small things that make your life easier. Or, if you are an asshole, they can make you do everything yourself.
3. Ditto for other medical technicians and therapists.
4. Following SOP in order to avoid mistakes is not just some nag by the nurse, it is necessary for the safety of the patient.
5. Discharge planning starts upon admission. Know your floor’s social worker (and chaplain, if there is one).
6. Don’t forget – you are part of a team.

The comment by Renee #11 is quite correct – doctors tend to treat patients as their diseases, as problems to be solved, and if they are specialists, they think about diagnoses in their specialty before they think of diagnoses outside their specialty. To a hammer, everything is a nail. Find a good general internist who can coordinate specialist info and can think outside a narrow box.

I read these posts with their hatred and vitriol, and, as a physician, I must make something clear to you all: your naked body holds no sexual appeal for me. You are a job. Nothing more. Now which idea scares you more: that you excite me, or that you bore me?

for more on how this comes to be a pattern for doctors, I recommend reading Heart Failure – Diary of a Third Year Medical Student, which describes how dehumanizing the process of becoming a doctor is and how they are encouraged to take it out on patients by dehumanizing them.

also included isthe revolting example of the author’s own experience at Tufts Medical Center in the 1990s, when they were having med students practice gynecological exams on unconscious women who had come in for other reasons, without their consent or even awareness that it was going to happen

This story made me vomit in my mouth a little. Ugh! Thanks for your take on the attitude of the medical establishment toward patients, PhysioProf. I’m not sure what the PA sexual assault laws are, but I hope this woman wins her lawsuit. This is beyond gross or troubling. It’s downright outrageous and it makes me sick that doctors feel they have the autonomy over their patients’ bodies to do anything they want to them.

This particular incident is some sick shit. Clearly, the doctor got some kind of thrill out of placing the tattoo where he did and, probably, knowing the woman would feel violated and scared when she found it.

I’ve rarely met a quack who wasn’t a pompous ass.
Med students should be required to study sociology or some kind of welfare-related subjects so they at least have a chance of understanding their own privilege.

I read these posts with their hatred and vitriol, and, as a physician, I must make something clear to you all: your naked body holds no sexual appeal for me. You are a job. Nothing more. Now which idea scares you more: that you excite me, or that you bore me?

Where the fuck do you get the cockamamie idea that this has anything whatsoever to do with “sexual appeal”? The entire fucking idea is that physicians/surgeons should just do their “job”, “nothing more”, and–like every other member of society–refrain from committing battery.

What scares people is that sick motherfuckers like you see the world through the lens of a depraved “excite/bore” dichotomy. Nice projection of your sick-fuck sexualized perversions on the rest of humanity, though.

William – I’m curious about your comment regarding psychiatrists. I have to admit that I know very little about what it is psychiatrists do compared to non-MDs in the field.

This summer, there is an undergrad who has been working in the lab and like many students at my (very medically oriented) university he wants to go to medical school. He’s a psychology major and he wants to become a psychiatrist but he is extremely socially awkward, to the point where his nervousness put me on edge. I’ve been wondering lately how that’s going to work out as far as dealing with patients, but like I said, I don’t really know what kind of things a psychiatrist typically does.

Dr. K. – I don’t give a rat’s ass about your opinions on my body’s appeal to you or anyone else. I want a doctor who listens as though I live in this body. I want a doctor who doesn’t think my body is something sie has a right to do whatever sie wants to. I want a doctor who cares about me as a person – not me as a disease.

Who the hell cares what your sexual urges are? I sure as hell don’t. Even if you did find my body sexually appealing, I want a doctor who’s professional enough to keep that knowledge to hirself and not make it my problem, or anyone else’s.

“William – I’m curious about your comment regarding psychiatrists. I have to admit that I know very little about what it is psychiatrists do compared to non-MDs in the field.”

In the US, at least, the tendency is for psychiatrists to focus on prescribing (which psychologists or therapists who aren’t also MDs or nurse practitioners can’t do) and the R&D of psych drugs rather than therapy or diagnosis. Like, a patient would get referred to a psychiatrist in order to get a scrip for xanax once the therapist has determined that they have an anxiety disorder, or for a lengthier consultation about alternative drugs if their prescription for prozac was working but also causing problematic side effects. I’d guess that they’re also the go-to folks for things like electroshock therapy, but the applications of things like that are fairly limited these days.

Fortunately I’ve so far only experienced the “I’m a doctor and therefore God” attitude once, but it was bloody painful! Every so often the ACL in my right knee “locks” and I can’t unbend it without excruciating pain. What usually works is going to A&E and getting a support bandage put on it and some crutches, and then it kind of “clicks” back into place sometime in the night. Sometimes they X-Ray it too, in case it’s something else. However, the third time it happened, the doctor who first looked at me in A&E demanded I try and stretch it out, saying angrily, “You’re not trying!” and then the other doctors yanked it straight. I screamed so loudly that all the other patients in the waiting room looked pretty freaked out when I came back out through there… it made it much worse and I was on crutches for about a week. I told them what had worked before, but they just didn’t care.

Dr. K said: You are a job. Nothing more. Now which idea scares you more: that you excite me, or that you bore me?
Neither scares me. Neither even particularly concerns me. What deeply disturbs me – and would scare me if I were in the care of someone like Dr. K – is the implication that I am not non-human. I am, in fact, much more than “a job.” I need to be related to as a full human being, especially by anyone who is going to come within several feet of my body for any reason.

“As someone who spends a substantial portion of his professional time teaching medical students, I can tell you that this kind of attitude–that physicians are gods, not mere mortals, and wield power over other human beings that no one dare question–is inculcated in them from the very beginning of medical training”

I find it difficult to believe that someone whose level of sophistication is this low and whose eagerness to propagate primitive stereotypes so strong could earn a Ph.D. in any field, be it aeronautical engineering or underwater needlepoint. Then again, we live in a world where, in very rare cases, surgeons tattoo their patients for fun, so anything is possible.

I actually went to medical school, and as someone who has always enjoyed warm and collegial relationships with countless Ph.D.s over the years while allowing for the inevitability of moronic outliers with doctorate degrees, I can affirm that PhysioProf’s claim is a crock of boiling shit. Humility was deemed just as critical to performing creditably in the profession as a thorough knowledge of organ systems and pathology.

I wonder, does he have a second blog called “why I resent M.D.’s” somewhere, or is that all between him and his therapist?

I’m pregnant. I was saying the other day that by far, the worst thing about pregnancy is dealing with all the doctors. I *hate* them.

Why is it I should trust a doctor to put his or her instruments in my body on the very first time I meet him/her? No. And when I say, “You know, I had one where I lay on my side and pulled my knee up, and that was much more comfortable”, replying, “That’s just for rape victims, and you’re not, so get up there” is just going to piss me off. Badly. Not to mention leaving me shaking and upset for several days.

I *hate* them. I have had two good ones. One left to get a specialty. The other I still have, but he doesn’t do maternity.

So help me god, if this next doctor I see next week is a douchebag too, I don’t know what I’ll do.

Yeah, surgeons. Ever tell ya’ll about the OB who started cutting on me during my c/sec before I was numb, and looked at me disbelievingly when I screamed? I’d like to put him naked strapped down on a table and awake and start waving a scalpel over his guts and telling him to “calm down.”

Owen, I direct you to your peer Dr. K up there. Clearly, you both are just full of humility.

Not all doctors are horrendous jerks. But there are enough of them that it’s a systemic problem in medicine that affects patient care. Consider all the doctors that don’t feel it’s necessary to wash their hands thoroughly before and after every patient. How could someone with so much medical training not realize that their carelessness is putting patients at risk for infection?

I’m not a doctor. I did not attend medical school. I do, however, know what a staphylococcal infection is.

I had surgery when I was 17, and I was told there was going to be bruising, and there was a SHITLOAD of bruising. I was ok with that because I was warned ahead of time, and it wasn’t in a random place underneath my underwear that was nowhere near the surgical site. If he genuinely wanted to “cheer patients up,” he would have taken a rose sticker and put it on the back of her hand, or gotten a little rose bowl for her room. This sounds more like a signature to me, like the guy really does think that human bodies are his canvas.

but rather implicit in the way that everyone else involved in the entire health care enterprise treats medical students, and then physicians/surgeons.

LMAO this is a joke and obviously spoken by someone who has never interacted with medical students in a hospital setting. Only a fool would say the dynamics of the hospital puts med students on any kind of pedestal.

PhDs extent of interaction with med students is in the research lab or in the lecture hall during the first year of med school, which has almost no bearing on clinical duties or reflect on what kind of bedside manner they are going to have.

PhysioProf is clearly too intent on hammering away his unsupported convictions to admit that the relationship between what this freaky tattoo-happy orthopod did and the psychosocial aspects of medical education is exactly ZERO (or maybe he is just stupid). This surgeon would clearly be ill-suited for employment no matter what line of work he was in. Who in his right mind would think that such a deed would go either appreciated unnoticed?

But that doesn’t mean the comenters here have to be ignorant as well. Are any of you going to get it through your heads that condemning this doc’s behavior doesn’t open the door to complaining about a bad personal experience with a surgeon, internist, or whatever? Yes, you should be disappointed and angry when you get substandard care, but how does that justify, or even relate to, the scattershot and primitive raving foisted on us by this infantile guest blogger with a grudge? (Maybe Mr. Prof said “fuck” too many times during his own medical school interviews, assuming he even got that far, and this is why he both didn’t get into med school and hates doctors himself.)

There is a difference between making mistakes or even a bedside manner that needs work and intentionally branding someone. And I emphasize once more that the last thing medical students are taught is that they are infallible. I think PhysioProf may have seen once too many movies starring Alec Baldwin as a cardiothoracic surgeon with a God complex.

I’d just like to echo what some of the doctors and medical students have already said. I am about to start my second year of med school, so I am the the type of student with whom PhysioProf would regularly interact. I can tell you that this “doctors as gods” attitude is certainly not taught (explicitly or implicitly) at my school (I’ll admit it is not a super prestigious university, but it is an allopathic med school). We actually have an entire 2-year course (3 hours+ per week) dedicated to teaching us to empathize with our patients. We talk about how to relate to patients from all different backgrounds, races, cultures, and classes. We learn about how to help patients deal with child abuse, spousal abuse, elder abuse, drugs abuse, etc. We have people come and talk about GLBT issues, and this is at a school that is not all that progressive. We are constantly told that the patient must be involved in his/her own care. We are taught that the patient should be given all of the information about his/her condition and treatment options and should then make his/her own decision about how to proceed. We discuss cases like the one in this post, and I know my teachers and classmates would totally disapprove of this guy’s actions. I can imagine this case being used as an example of how we are not supposed to act!

I’m not sure how the previous generations of doctors were trained, but I hope that everyone here knows that the current crop of med school grads is made up of men and women who have been trained to respect patient autonomy. Obviously, I am still very inexperienced (I just finished my first year!), and I don’t know how they teach during the clinical years (the third and fourth years of medical school) and residency, but I would think that the students PhysioProf interacts with are being trained in much the same way that I have been. If the PhDs at his school are anything like my professors, they probably don’t do much to make the medical students feel superior. Our professors, of course, know way more about their subjects than MDs ever will, and they are sure to let us know it during lectures and tests!

Sorry to ramble, but I am a regular reader of this blog, and I notice a lot of anti-MD comments. I realize that there are some arrogant, patronizing doctors, but I feel that there are many more good doctors than there are bad ones, and I think the current generation of medical students will be even better.

Owen Bideway, it’s pretty clear that PhysioProf used the tattooing surgeon as an example, perhaps a “far-out” example, of the general arrogance and lack of humanity of many medical doctors. He linked that to medical education and I’d say that comprises a social link as well. I’ve had WAY more experience with doctors than I could wish and have spent far too much time in hospitals, either as a patient myself or as the advocate of a relative or friend. I consider doctors as hostile actors in hospitals or in their offices, unless they prove otherwise and nothing at all has happened to make me reconsider.

And here’s another anecdote for ya: I attended a surgeon’s office with my brother-in-law who was diagnosed there with Stage IV otolaryngeal cancer. A death sentence. My brother-in-law sobbed for a moment, then took a breath and addressed this question to the surgeon:

“What should I do, I’m dying then, what should I do Mr. X”.

The physician replied, “It’s DOCTOR X. I haven’t been a MISTER in thirty years.”

How come none of the doctors are as outraged by the mortal insult to their profession caused by the surgeon in question as they are at PP for this post? Why are they not more concerned over the perceptions of patients that some (actually quite a few, apparently) doctors have crap-ass bedside manner? Instead of insisting that from their perspective everything is just ducky? Frankly all you are doing with these comments is to confirm PPs assertion that you doctors have a tendency towards arrogance and asshattery…

BikeMonkey – actually Owen has already said that he thinks the tattoo was completely inappropriate.

However I suspect the reason they are getting worked up is because of the sweeping (and offensive) generalisations being made. The argument here is along the lines of “Dr X did something creepy, illegal and dickish, therefore most MDs are dicks”. If someone made such an argument about my profession I’d get pissed off too.

Also since this seems to be a thread entirely based on personal experience I’ll say that i dont work with MDs (and none of my family are MDs) but the ones I’ve dealt with have been great. Also the medical students I knew at uni were great people. Although the thought of being operated on by anyone who killed that many brain cells with their drinking at university is kinda scary ;) They certainly didn’t come across as thiinking they were “teh uber godz”.

Although I live in the UK I have difficulty believing that the US medical culture is so vastly different that MDs systematically are that arrogant.

@BikeMonkey: The damage of the surgeon to the profession has been done and will, undoubtedly, be dealt with not only by the courts but BY THE PROFESSION when his medical license is suspended or revoked. His behavior is clearly egregious. It is also WELL outside the norm, despite the many anecdotes published here. PP’s behavior is ongoing damage that is unfounded and is therefore being repudiated. Furthermore it is an attempt to lump a significant portion of, if not all, physicians, in the same category as the surgeon. BECAUSE we are extremely upset at what this surgeon has done (and not because of the mortal insult to the profession, but because of the mortal insult to the PATIENT) that is exceptionally offensive.

The quality of evidence presented for the claims being made here is abysmally poor, particularly for people who are scientists. PP, how often do you spend time in the OR? When did you last do so? How many different surgeons have you seen operate? What percentage of the time did you witness behavior that you would characterize as “basically functioning as dictators” and how do you define that behavior in a way that would be replicable by someone repeating your study? I see no foundation for your conclusions.

BikeMonkey, you base your statement that “quite a few…doctors have crap-ass bedside manner” on exactly what? The 15 of 44 comments (I exempted from the count the trackbacks and the “sorry, just to clarify” posts) that had or alluded to anecdotes of poor bedside manner? From an open, self reporting, internet comment group? You’ve got to be kidding.

This whole tirade smacks of deep seated resentment and confirmation bias. It looks like you are using this despicable incident solely to further your own agenda, which is itself pretty despicable.

“Owen Bideway, it’s pretty clear that PhysioProf used the tattooing surgeon as an example, perhaps a “far-out” example, of the general arrogance and lack of humanity of many medical doctors.”

‘Far-out’? It’s senseless. Using what this surgeon did to support the idea that future MDs are encouraged to be arrogant is as irrational as claiming that NFLers who get in bar fights are encouraged by the league to become violent in all aspects of their lives. Just as those idiots bring their problems with them to their chosen careers, this idiot surgeon unquestionably was a creep with or without his medical training.

If you don’t believe me, explain how a different classroom atmosphere (not that you or PhysioProf himself know what this consisted of) could have prevented this episode. Should medical students be given a lecture in their first year about not writing things on people while they’re under anesthesia?

This post is a bad joke, and PhysioProf had made something of an apology so there’s no need to carry on with a load of folks with preexisting grudges against the whole profession.

” Using what this surgeon did to support the idea that future MDs are encouraged to be arrogant is as irrational as claiming that NFLers who get in bar fights are encouraged by the league to become violent in all aspects of their lives.”

Um, that analogy is supposed to convince me that you are the one that is right?

Because I don’t know about you, but to me there is a fine line between “encourage” and “turn a blind eye to stuff you damn well know is going on.” I rather think the same applies to the medical profession. Medical school may or may not make future doctors more arrogant on average than most people, but it sure doesn’t do a whole lot to discourage it, even though they know damn well it’s a problem that’s been around for a while.

And peoples? Complaining that medical students are the peons of the medical establisment is hardly proof that PhysioProf is wrong. Seeing as how basic psychology tells you that the easiest way to make a bully is to find somoene who is at least a little arrogant, treat them like shit for a while, and turn around and give them a lot of power. Physio never said that medical students get treated like gods compared to doctors, the asseertion was that physicians are held up as gods. Which is pretty much in line with how professional gruaduate programs work overall – only dangerously more so.

I don’t know if this adds to the conversation but for six months I dated a man who’s sister was a prominent ob/gyn married to a infectious disease specialist, a brother who was a heart surgeon and father who was a primary care physician. Listening to them at the dinner table consisted of a myriad of topics that all came to the same conclusion: patients are stupid, patients don’t respect them, patients are annoying, etc etc. They never took any accountability for their behavior or actions. I once made the mistake of telling the ob/gyn about a friend of mine who, after countless interventions during her labor including painful vaginal exams by a lot of people that she tried to refuse but was forced to endure, she bled out and almost died. I got the tell-off of my life.

Since then I have made it a point to ask every physician I see point blank what their views on patients are. Some laugh in a way that they know what I’m getting at while others have stuttered over their words in disbelief.

This story is an extreme example- but it is indicative of the holier-than-thou attitudes many physicians have.

“Although I live in the UK I have difficulty believing that the US medical culture is so vastly different that MDs systematically are that arrogant.”

Oh, believe it, Bexley. I lived over 20 years in the US and offhand the ONLY doctor I can remember who treated me well was an opthamologist I went to as child. All the others were bad, either because they didn’t listen to a word I said or because they really were head-up-ass arrogant fuckheads.

Then I lived in Spain for a long time, where the doctors were better, but to be honest I rarely visited one.

Then I moved to the UK and all I can is GOD FUCKING BLESS THE NHS! (and that comes from an atheist) I cannot believe how good it is here: not only do most doctors not look at you like a piece of shit that got tracked in to their offices, not only do they not only not roll their eyes like sulky teenagers at the idea of having to, y’know, do their fucking jobs by dealing with you, when you talk, THEY LISTEN TO YOU AND (gasp!) RESPOND IN A HELPFUL WAY!!!

No, I’m not joking: it really does happen! Since moving to the UK, several problems I’ve had all my life are finally getting some treatment because for once there’s a system in place that gives a shit about the patient.

Yes, there are some bad eggs: I once went to a consultant gynecologist who patronised me and assumed he knew everything about my life after ten minutes. And I had another once who was a bit dotty and came out with a load of weird non sequiturs. But on the whole, for the first time in my life, going to the doctor is not something I dread.

Whenever I hear people criticising the NHS, I have to agree with a Brit friend of mine, who has moved to a country in Latin America with no public health care: those people don’t know they’re born. Let them live somewhere like the US for a while, then they’ll appreciate what they’ve got.

And for all the crybaby MDs who are flocking here to whinge about how unfair it is that mere mortals dare criticise them instead of prostrating ourselves before them as they believe is their due: have you not read the story upon story of arrogance and incompetence in this thread? We’re not asking your opinion, we’re fucking TELLING you that MD’s in America have, in general, shit attitudes and that makes them, in general, shit practitioners. Why don’t you try taking on board what people are saying for a change instead of throwing yourselves on the floor, kicking your heels and screaming? JeeZUS.

And, just for the record, my mother was an RN and my dad a pathologist. So, lucky me, I also got to deal with loads of MDs in our home. And yes, they were just as insufferably arrogant in their private lives as they were on the job.

Man, I can’t stand people that generalize about physicians or surgeons. Or, for that matter, anyone.

Those of you who are bashing surgeons: Grow the fuck up. Not all surgeons are this way. Some suck, yes, but the vast majority are competent. And I’ve never met an arrogant one, myself; I may be lucky, but not all of them have a stick stuck up their ass. (I was a pre-med before I decided I’d rather get a PhD because I like research more – I’m now a pre-PhD; I’m currently an undergrad student, and I’m a neuroscience major.) I had surgery a year and a half ago and my surgeon was probably the least arrogant person I’d met there; in addition, my father’s neurosurgeon operated on Laura Bush’s spine and Bob Barker’s brain, and he was, if I remember my father’s neurosurgeon, a fairly nice neurosurgeon.

Rather than fling stereotypes, we should be addressing the causes of these stereotypes.

“so it sounds like psychiatrists don’t actually interact with patients that much. Their expertise is more on how to prescribe psychiatric drugs, is that right?”

I think it would be more accurate to say that their interaction with patients is usually on the normal to low side for a doctor but quite reduced for a counselor. There’s nothing keeping psychiatrists from also being fully trained, competent, experienced therapists, but there’s also nothing mandating that. They’re not necessarily psychologist/doctors, and they can wind up being doctors whose academic experience with psych is minimal and training in counseling is far overshadowed by their training in pharmaceuticals and strict medicine.

It’s something of a numbers game. The requirements you have to meet and the money you have to shell out in order to become a psychiatrist are a lot higher than for a psychologist, so you have fewer of them. Because of the educational cost and comparative rarity, their services cost more; patients can’t afford to see the psychiatrist like they would a therapist. Because the psychiatrist can do something fairly important to normal counseling–prescribing medication, consulting with patients who are experiencing problems with the meds they’re on, designing regimens for patients with complicated diagnoses, etc.–that regular psychologists aren’t trained for, they tend to get plenty of non-therapy work through therapist referrals. So not only is there economic pressure to limit therapy work if possible, but there’s also no incentive to not suck at it–it’s not the only thing they can do, and the non-therapy part of their duties are pretty vital to mental health care.

It’s not like if a therapist sucked at therapy, where it pretty much guarantees a terrible or truncated career. People are more willing to put up with a dick psychiatrist if they only have to see them twice a year for fifteen minutes than they would be a dick therapist who they’re supposed to be seeing twice a month for a full hour. There’s also more of a cost-benefit analysis going on. You’d never keep going to a therapist who had terrible people skills and outdated or weird ideas about counseling, but if you have a psychiatrist who’s got that going on but they’re absolutely stellar about keeping up with the latest news and research on medications, making sure you have all the information you could possibly want about what you’re taking, explaining how the medications work, etc., you might make allowances.

None of this excuses the psychiatrist who dismissed the PTSD patient’s concerns, of course. It would be a jackass move even on the part of a general practitioner to give a bullshit, combative answer to a reasonable request from a patient who was made uncomfortable by the situation as it stood. Coming from someone in the mental health field, though, it’s jaw-dropping. Even a first-year psych student should be familiar with a) PTSD and b) the idea that a patient feeling physically threatened is not at all conducive to a beneficial encounter and is therefore to be avoided if safely possible. It’s just part of why you tend to have a greater percentage of psychiatrists being bad at dealing with patients who need counseling. There are way more therapists out there who are pretty crap at their jobs, numerically speaking, but your odds of any given therapist being crap at therapy is lower.

As posters above have said, its just as derogatory to bring these stereotypes in when you see your doctors. I don’t care how many bad experiences you have, but making generalizations about the majority of profession is prejudice which in general is against the feminist movement. If I were to say I have met “a lot” or “countless” black men or “taught in a school with mostly black men” or “dated a guy who family knew someone whose whole family knew black men” and with this experience I knew all black men are violent, people would (rightfully) call me a racist.
The point is that its easy to make assumptions. Its easy to believe what your small worldview or limited experiences have shown you. Feminism or humanism is about trying to understand your views of the world are limited by your life. If we really want others to do it, we probably should do it ourselves. (and I include myself in this)

peri9;
I respectfully disagree with your argument. If, for example, I had a pair of shoes that needed to be repaired and after witnessing countless times cobblers talking about their customers being stupid, annoying, etc because they questioned their work, I think anyone would think it appropriate if I was extra careful with the cobbler I choose to repair my shoes. A doctor is no different. They are providing a service and we pay dearly for that service. My health insurance just went up again this year. We want to be respected, just like any consumer, when we purchase their service. Because health insurance in this country is a private entity, I don’t understand why patients treat it any differently then other private institutions we may use.

Jackie: so what is the minimum number of people I need to meet within a given demographic before I can justify prejudging everyone else in that demographic?

I’d say to everyone that has a beef with physicians in general that if you go see a physician with the expectation and attitude that she’s going to be an asshole that message will probably come across and you are likely to have that expectation confirmed. Just like anyone, a physician isn’t likely to extend herself emotionally in the face of hostility.

As to your point about health insurance, I’m sure you realize that physicians don’t set insurance prices, insurance companies do. I think you’ll find that insurance company executives get paid a whole lot more than physicians. Perhaps your justifiable anger at the insurance companies should be directed at the people running those companies.

Actually I think the insurance companies are to some degree at fault for the breakdown in relationships between patients and physicians. You buy into the process that causes the problem, subconsciously I think, yourself. You make the argument that a physician is no different than a cobbler, and that a person seeing a physician should be treated “just like any consumer” purchasing a service. NO! This is NOT the type of relationship a physician and patient should have. There should be mutual trust and respect. The patient and physician should work as a team to solve the health problems of the patient. It is precisely this change toward thinking of patients as “customers” that promotes the kind of behavior you are opposing. A customer purchasing a service has no claim to and cannot expect any relationship with the seller of the service beyond an agreed upon exchange of value. Sellers may provide things like good customer service or warrantees to encourage customers to choose them, but this is voluntary and undertaken to improve business. If you want to improve physician-patient relationships we need to encourage LESS of this sort of thinking and work to build partnerships between physicians and patients.

better yet, peri9 is essentially saying that it’s not feminist to be a feminist.

After all, it can’t possibly be true that women tend to get overcharged and condescended to by professions, like auto repar and plumbing, that have fewer women working in them. Because to say that would be the same as saying that men are better electricians than women.

wha?

The only thing I can figure is that peri9 believes either that there are no trends to be observed, or that all observations are equally true/insightful.

Erik;
“I’d say to everyone that has a beef with physicians in general that if you go see a physician with the expectation and attitude that she’s going to be an asshole that message will probably come across and you are likely to have that expectation confirmed. Just like anyone, a physician isn’t likely to extend herself emotionally in the face of hostility.”

Who is saying anything about acting like an asshole? Asking a physician a question is acting like an asshole and is hostile?? Really? Well how can you “Work together as a team” with your physician as you say if a question is hostile??

As far as your whole insurance company argument goes- Wasn’t it the AMA that was one of the strongest opponents of socialized health care in the past? There are a lot of hands in the pot- the whole system is broken.

Sorry but when it cost thousands of dollars out of pocket to have a baby (if your lucky enough to have health insurance) or a surgery, I want the best care possible and to me that means making sure the doctor I go to does not harbor the type of holier-than-thou attitude I have witnessed from doctors in their exam rooms as well as in their private settings.

Jackie,
I think you misunderstood my antecedent “she’s” in that first sentence; it refers to the doctor not the patient. As in: if the patient expects the doctor to be an asshole, or holier-than-thou, or have a god complex then this expectation is likely to be communicated and will get things off on the wrong foot. And yes, depending on how a question is asked (both the words used and the nonverbal cues that go along with it) it can be hostile.

For example, rightly or wrongly, I interpret your use of multiple question marks as a sign of high emotional content and the context suggests that you are disagreeing with me. Hence I perceive your question as angry (although not really hostile). Communication goes both ways. Physicians say things that are justifiably taken badly by patients, even when they are not intended that way. Patients can certainly do the same thing with physicians. It isn’t reasonable to expect that physicians will always say and do the right thing, much as we should always strive to do so.

I agree that the whole health care system is broken, and there are more reasons than just socialized health care why I’m not a member of the AMA. But the AMA doesn’t set insurance company rates or their executives’ salaries. Most physicians I know hate the insurance companies almost as much as most patients do. Dealing with insurance companies is a leading reason physicians give for leaving the profession.

Everyone should get the best care possible. This would be true if it cost only a $10 copay to have a baby just as much as it does if it costs $1000. You are still clinging to the notion that the doctor-patient relationship should be based on finances, which I firmly reject. Since you don’t seem to buy my suggestion that the doctor-patient relationship should be a team effort, how would you propose changing the system to eliminate the holier than thou attitude? I can’t see how either paying physicians more or less would affect the problem.

I think erik actually made my point better. I don’t think it”s fair to make assumptions of all doctors, or the next doctor you are going to see based on past experiences. I think that idea is against feminism. Doctors are large diverse group and should be treated as such. Obviously prejudice, even when not overtly stated, affects the encounter, as erik stated.

Mickle, my point was not that doctors have no prejudice towards patients, I definitely don’t believe that’s true. I was trying to say that patients (or atleast posters on this wall) seem to respond to doctor’s prejudice with prejudice of their own, and that is not feminist. Or productive.

ERik, I misunderstood you and I apologize; however, you are assuming that my attitude or questions come off as hostile which is not true.

The AMA may not set insurance rates but they support the institution. I’m not going to buy into the idea that physicians are just innocent victims of a corrupt system. Doctors benefit tremendously from private health care.

Under your reasoning, if I don’t take the shortcut down the alley near my apartment late at night because a few guys are hanging out there then I’m not feminist because I am making an assumption that they could hurt me based off of past experiences.

I didn’t mean to imply that you specifically were hostile, but I can see how you would have thought so. Sorry about that. I really just meant to make a general point.

No doubt that physicians benefit from private health care, and many of them are opposed to reform of the system. But the insurance system is a separate problem that doesn’t have bearing on the issue addressed in these posts.

I’d really like to know how you and others who think physicians are arrogant to the point of detriment to the physician patient relationship would propose reforming the system.

What an ass (not you PhysioProf)! His medical license should be revoked.

What an absurd overgeneralization (yes, yours PP). Do you have any concrete examples of how “this kind of attitude–that physicians are gods, not mere mortals, and wield power over other human beings that no one dare question–is inculcated in them from the very beginning of medical training”?

“I was trying to say that patients (or atleast posters on this wall) seem to respond to doctor’s prejudice with prejudice of their own, and that is not feminist. Or productive.”

And I was pointing out that you are comparing apples to oranges and claiming that since they are both fruit, what is true for one is true for the other.

First of all, no one here has said that doctors can’t be unprejudiced or even that all doctors are (greatly) prejudiced.)

More importantly, you are completely overlooking the imbalance in power between patients and doctors. Even if I was as prejudiced about doctors as I suspect a great number are about me as a patient, their prejudice goes beyond simply unproductive.

And I say this as someone who just dealt today with a very prejudiced library patron. As annoying as it was to deal with his crap and then have to finally kick him out when he became verbally abusive, it’s still a whole world away from me, a manager, being abusive towards him, a homeless patron. For example – see the part where I was able to kick him out the library once he had crossed the line. Obviously, he doesn’t have the same power over me. My (hypothetical) prejudice towards the homeless would be far more lasting and have far more serious consequences than his (confirmed) prejudices towards government employees.

I find it amusing that peri9 and erik are trying to class MDs as some sort of ethnic/racial group. Sorry to break it to you, but they’re not, they’re a group linked not by ancestry or religion or language or nationality, they’re linked by PROFESSION.

And, at least on our planet, Doctor of Medicine is one of the professions with the greates amount of social prestige.

So oppressed, they’re not. Not by any stretch of the imagination.

Look, a huge number of MD’s have zero respect for their patients. I know this, you know this, we ALL know this. We, as patients, are saying that we’ve had about enough of being condescended to, humiliated and receiving substandard treatment due to doctors’ inability to related to us on a human level.

Why are you so surprised to find that, when you treat people like shit, those people tend to not like it?

I’m met a lot of doctors, surgeons and other medical folks in my 39 years, and the vast majority displayed concern about me, listened to me (for not as long as I liked, but they did listen), and tried their best to help me. Funnily enough, most of them seemed to have entered the field because they wanted to help people, and it showed. Sure, I’ve met a few jerks too, but only a few.

Does anyone think there might be some confirmation bias going on here, both in the original posting and the majority of the comments?

I call BS. Yeah, some doctors are arrogant pricks. Doctors are, after all, people — and some people are arrogant pricks as well.

I’m in no way a medical professional (I’m a computer geek), but my family often trusts me to go with them when visiting a doctor (or lawyer, etc.) to be an attentive note-taker. Given the severe problems that have arisen in my family (from which, thankfully, I have mostly been spared so far), I’ve had more opportunity to speak and interact with members of the medical profession across various specialties than most.

I’ve encountered a few jerks. Vastly more often, though, my family and I were treated with respect, concern, and courtesy. The only general criticism I have of the medical profession is how *rushed* everyone was; but even so, most were understanding and willing to answer any and all questions about treatments, risks, alternatives, and so on. Many times I’ve had professionals tell me “I think it’s this, but it’s hard to diagnose; I suggest you get a second opinion”.

Perhaps instead of railing against the whole profession — which, by the way, immediately condemned this surgeon for his actions — we should focus our outrage on the individuals within it that treat people poorly.

Put another way, if your doctor is a jerk, TELL HIM (or her) — then go see another doctor.

I think any communication is a two way street. If you are going to be disrespectful to the doctor, he will ultimately be disrespectful to you. Your attitude toward physicians will be picked up by him/her. Maybe some of you, including Physioprof, should shadow an intern or resident for a week.

awesome thread, got to see lots of neat ideas tossed around, but as many people have already stated isn’t taking a bunch of anecdotal evidence from a bunch of people using confirmation biased….well biased. There seems to be a lot of anti health care/massive rise in psuedos medicine. There will be lots of people with gripes against docs. It’s akin to saying all mexicans love tacos, because based on my anecdotal eveidence, well Im mexican i l ove tacos, so is my brother, and my son. hmmm that means all mexicans love tacos. As we see this form of logic is to say off? We all know that not all mexicans love tacos. So see the bigger picture physioprof hates docs, and I like…..hrmm…love tacos, thanks for taking time to read (im sorry if some spelling is bad it’s 2:30 AM brain not running on full speed)

First, I agree that the surgeon mentioned was unprofessional in the extreme. I do take issue with the notion that all doctors think they are God because they have a medical degree.

I have never met a doctor who treated me with anything but respect and kindness. I have never felt looked down upon in a doctor’s office. You people who claim that good doctors are the exception to the rule have got it all wrong. Crappy doctors are the exception. (For the record I am not a physician and I have been to a lot of different doctors because I moved around a lot when I was younger.)

Also, I don’t understand the whole doctors having power trips notion. The way I see it doctors are there to help me feel better. I’m the one with the power. I can ask as many questions as I want. I can tell the doctor I don’t want to take that medication. I can refuse a treatment. I might be wrong, but it’s still my choice.

I have to say I’d take this a whole lot more seriously if this wasn’t coming from a Physiology prof. During the basic science years of my med school (yes, I am a physician, I admit my bias), we medical students were constantly harangued by our Physiology, Biochemistry and Cell Biology profs for being “too stupid”. Despite the fact that we had neither the same academic background nor were taking the same courses as the PhD students (PhD students have the luxury of specializing in often very specific fields, whereas medical students and premed undergrads have to take a wide variety of courses in a wide variety of fields and don’t get an opportunity to specialize until residency or later), it seemed that many of our basic science profs were holding us to the same standards to which they held advanced PhD students – and when we inevitably failed to meet those standards (daring, for instance, to ask the prof to clarify a concept), we were told that every last medical student was unworthy of the basic science profs’ genius.

PhysioProf sounds exactly like the Physiology, Biochemistry and Cell Biology profs I had in med school. Hopefully they represent a minority of basic science PhD’s – unlike some people I try not to generalize an entire professon based only on a few people I have personally met.

Sorry I’m late to the party. As a resident, I must point out that if I did “just my job,” or even talked about it as “just a job,” I’d get fucking fired–or at the very least, talked to in a hushed tone.

Patients want us to be MAGIC. They want us to make things happen that only a god could make happen; they expect miracles; the only honest statements many of them want from us are the ones that reassure them. If you think patient expectations (evidenced neatly in the comments above) play any less of a role in God complexes than physician education does, especially with patient satisfaction being such a huge market force, you are living in a fantasy world with fairies and unicorns and skeletons doing it doggy-style.